Tummy Tuck with Diastasis Recti with No Fat or Excess Skin?

I went to my first consultation and my doctor doesn't recommend a tummy tuck for my Diastasis Recti. I work out 5 days a week and being 55 I am very fit. My doctor said I don't have any fat to lipo and no loose skin to stretch. My Diastasis is pretty bad (up high) and my abdominal muscles are strong but very separated. He wants to make a small incision under my belly button and go through there. Any suggestions? How can he see up there without the skin removed? Thank you. CB in Florida

Doctor Answers 5

Mesh treatment for Diastatis Recti

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Since you workout you probably have very strong rectus muscles and you are very thin so they may show through the skin.  The fascia surrounds your muscles and connects the two across the midline.  If this fascia has been stretched and damaged it will need to be repaired.  Simply placing sutures that pull the two recti muscles together will not last.  When the muscles are contract the sutures will tear.  A better technique is placement of mesh.  My usual procedure is an abdominoplasty incision and the mesh is placed under tension and secured firmly.  There have been recent articles published in Plastic and Reconstructive Journal describing this technique.  You may be a candidate for the procedure but without photographs I cannot say more.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Tummy Tuck for Separate Muscles

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A standard tummy tuck usually includes removal of excess skin and fat, as well as tightening of stretched rectus muscles.  If your rectus muscles are widely separated, which is the definition of a diastasis recti, then that condition can create an unsightly forward bulge of the belly wall.  This can be corrected through a small incision near the belly button (umbilicus) by using an endoscope.  I have done this before both from the belly button upward and from the pubic area upward.  However, depending on how widely separated the muscles are, your skin might need to be undermined widely to allow the skin to redrape evenly after the muscles are tightened, and although this skin undermining could theoretically be done through an endoscope also, it might be more helpful to use a longer incision in the suprapubic area.

Richard G. Schwartz, MD
West Palm Beach Plastic Surgeon
5.0 out of 5 stars 32 reviews

Tummy contouring recommendations

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Its impossible for anyone here to make any recommendations without of formal physical exam.  If you are not sure about the recommendations from your first consult, please schedule a 2nd consult.  Only visit with a board certified PS to learn more about your options.


Diastasis without excess skin

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Without any skin excess and a diastasis alone it might be possible to correct the diastasis through the belly button. We prefer to use a short C-section like incision and tunnel to the top and repair the diastasis top to bottom. We just feel the visibility is better and we have an easier time smoothing out the skin.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Diastasis Recti with No Fat or Excess Skin

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The question you raise would best be asked of your surgeon. It may be that this will be a laparoscopic procedure, which would give an explanation fo how he could see.

The one issue is that if you have a really wide separation of the muscles, closing the wide space may result in buckling of the skin that will be carried along with the muscle, so doing this with a tummy tuck incision could be a better approach. If you have any questions, a second opinion would be worthwhile.

Thanks and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.